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PODCAST

Dr. Chapa’s OBGYN Clinical Pearls

Dr. Chapa’s Clinical Pearls

Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.

science

All Episodes

00:38:02

Persistent Genital Arousal Disorder: It’s a Real...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/16

Persistent genital arousal disorder (PGAD), now called Genito-Pelvic Dysesthesia, was first described by Leiblum and Nathan in 2001 in a five-patient case series. This is now a well-recognized pelvic floor/genital abnormality with a consensus statement being released in 2019 by the International Society for the Study of Women's Sexual Health. Are you familiar with this condition? It is a source of severe emotional and mental hardship for those affected. In this episode, we will summarize the data on

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00:25:00

Recurrent AB? STOP Checking This! (ALIFE2 Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/14

The definition of recurrent pregnancy loss (RPL) in the US is 2 or more consecutive failed clinical pregnancies documented by ultrasound or histopathology, while, in the United Kingdom, the definition is as having 3 or more consecutive early pregnancy losses. Up to 50 percent of cases of recurrent pregnancy loss lack a clear etiology. Where do we stand, in 2023, in regards to our understanding of the effects of inherited thrombophilias on recurrent pregnancy losses? Do they cause recurrent ABs? Does

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00:36:45

Does Perineal Massage Prevent SVD Lacs? New Data.

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/12

Perineal trauma after vaginal birth is common, with approximately 9 of 10 women being affected. Second-degree perineal tears are twice as likely to occur in primiparous births, with a incidence of 40%! Obstetrical lacerations of all degrees can lead to significant physical and even psychological morbidity, and have been identified as an independent risk factor for sexual dysfunction- which could last up to 18 months after delivery. Can perineal massage help reduce the rate of obstetrical trauma at

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00:20:58

Understanding ZURZUVAE™ (zuranolone): The First Oral...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/10

In 2019, brexanolone, better known as Zulresso, became the first postpartum depression (PPD) drug to receive FDA approval. While we have previously discussed this IV medication for PPD in other episodes, there is now a novel oral version of this antidepressant which has made the news as of last week (ie, early august 2023). That medication was known as SAGE 217 during the clinical trials, but it is now known as zuranolone (ZURZUVAE™). YEP.. in the first week of August 2023, the US Food and Drug

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00:14:27

Brand New TXA at CS Data: Shout out to KC et al!

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/08

In our most recent episode on vaginal prep at C-section, we referenced a parallel topic where individual data pieces seem to be contradictory: prophylactic TXA at time of cesarean section. In that past episode, we referenced a systematic review and meta-analysis that showed prophylactic TXA was indeed beneficial. Well… we are going to build on that data regarding prophylactic TXA in this quick/targeted episode that we call our NEW DATA BLURB. In this episode, we will highlight a fantastic, brand

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00:40:55

Vag E2 After Breast CA: Nah or Yeah?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/07

With improvements in the screening & treatment of Breast Ca, the number of female survivors continues to rise, with a reported 5-year survival rate of up to 90%. However, several of the systemic treatments for breast cancer, including endocrine therapy, chemotherapy, and radiotherapy, can result in a new or worsened hypoestrogenic state. Up to 70% of postmenopausal women will develop symptoms of genitourinary syndrome of menopause (GSM). With an estimated 3.8 million breast cancer survivors in the

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00:25:15

To Vag Prep or Not to Prep: That is the Question (Aug...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/04

CS is the most important risk factor for postpartum infection with a 20-fold increase compared to the vaginal delivery route. For post-cesarean section metritis, infection is considered to be primary due to ascending bacteria from the vagina. Although antibiotic prophylaxis is thought to reduce postoperative infections, it has little effect on bacterial colonization of the vagina. Over the past 20 years, multiple randomized clinical trials have investigated the effect of preoperative vaginal

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00:41:07

VTE Med Prophylaxis After SVD?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/04

Venous thromboembolic events (VTE) are among the top three causes of maternal death in developed countries and prevention with thromboprophylaxis has been identified as the most readily implementable means of reducing maternal mortality from VTE. Most guidelines address VTE prophylaxis after cesarean section, and/or in those with thrombophilias- not after vaginal delivery alone. The ACOG does not directly address inpatient pharmacologic thromboprophylaxis during antepartum admission nor after

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00:37:21

Kratom & Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/08/01

We are still in an opioid crisis state in the US. Have you heard of Kratom? It is likely at your neighborhood health food store or even on the counter at your local gas station. A derivative of the coffee plant, Kratom is making national headlines. Whether Kratom, a legal, widely available herbal supplement, should be classified as an opioid is contentious. Although the US Food and Drug Administration has recently addressed this controversy, Kratom continues to be marketed as an over the counter,

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00:42:40

The “Rule of 55” For HDP: A Critical Review of a New...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/30

In 2019, the ACOG released CO 767 discussing “Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period”. currently, 3 meds are recommended for the treatment of emergent hypertension in pregnancy: oral nifedipine, IV, labetalol, and IV hydralazine. But which one is “better” at normalizing blood pressure? A new meta-analysis, published on July 24, 2023, provides one answer. However, this meta-analysis did not take into account the most crucial factor determining

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00:23:05

NEW HPV Vaccine ADVISORY: Use After CIN2+ Therapy...

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/28

We have learned so much about the natural progression of HPV induced cervical abnormalities. In 2019/2020, the ASCCP published its updated guidance using a “risk-based” algorithm for management of cervical intraepithelial neoplasia. Traditionally, HPV vaccination was considered ineffective once cervical dysplasia already was present. But recent data has proven this concept incorrect! In this episode, we’re going to summarize a brand new ACOG practice advisory released today, on July 28, 2023,

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00:34:05

Amniotic Fluid Injections? 😳💉💉💉

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/26

There are, indeed, FDA indicated applications for purified, amniotic membrane (wound healing). Is there also a role for the use of purified amniotic fluid as a “regenerative medicine” treatment option? Can amniotic fluid injections help repair osteoarthritis and aching joints? Can it be used as EYE DROPS for dry eyes? The subject is trendy on certain social media channels and on certain websites. But this concept of injecting amniotic fluid into various body locations has landed one Texas healthcare

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00:40:13

HS in Pregnancy

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/25

Skin conditions can't affect pregnancy outcomes, right? After all, the skin is just the skin. WRONG! As a chronic inflammatory disease, hidradenitis suppurativa (HS) exemplifies the link between integumentary and comorbid systemic disease through shared inflammatory pathways. Patients have double the comorbidity burden compared with the general population, and hidradenitis suppurativa has independent associations with several individual comorbid diseases. During pregnancy, HS also is associated with

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00:40:22

AHA BP Cutoffs Helpful in Pregnancy? (Aug 2023 Data)

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/23

In Feb 2023, the USPSTF recommended that clinicians “screen for hypertensive disorders of pregnancy”. Specifically, they stated that “measuring blood pressure at each prenatal visit is the best approach”. Mind blowing I know. 😳😊 But sarcasm aside, a new publication- set to be released next month in AJOG (Slade LJ et al; Aug 2023)- validates this recommendation…not that it needed validation, for frequent BP monitoring during pregnancy. This has to do with the “sensitivity” of BP results in

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00:36:31

BV RX to Prevent PTB?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/22

On April 5,2023 the U.S. FDA withdrew its approval of Makena and generic forms of 17-a hydroxyprogesterone caproate for the prevention of recurrent preterm birth. Having the only medication which had been FDA approved for the prevention of preterm birth taken away, has left clinicians investigating other possible strategies that can cause a dent in preterm birth rate. As Bacterial vaginosis (BV) is the most common vaginal abnormality in reproductive age women, naturally the spotlight would fall on

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00:01:38

Up, Up, and AWAY!😊👋😊👋😊

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/14

FYI. We just released our episode for today, July 14, 2023, and will be out until July 23!

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00:34:23

Does Walking Induce Labor? 🚶‍♀️🚶‍♀️🤰

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/14

Its hard to be pregnancy in the late third trimester, especially in a HOT state like TEXAS in the summer. Pregnant individuals will try just about anything "to just get this baby to come out already!" Historically, walking, spicy foods, and SEX have been "employed" to get the labor process going. Does it work? In this episode we will look at the data examining whether labor can induce spontaneous labor. Is this a myth or a real thing? What about CURB WALKING?! That works, right? Lots to cover and

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00:33:04

False Positive “Confirmation” Syphilis Test?

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/13

There’s no such thing as a “false positive syphilis confirmation test”, is there? After all… It’s right there in the name, CONFIRMATION test! Well, not all positive confirmation tests are true positives, especially when that test is the FTA-ABS. Yes, it’s true, the specificity for this is very good between 95 to 98%. But there are cases of BFPs (Biologic False Positives), which have been reported and published in the literature. This is why putting the test results in clinical context is very

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00:33:46

The Bandl Band

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/11

The Bandl Constriction Ring. It is real. It exists. Its true incidence is unclear as it lacks uniform reporting when found at time of cesarean. As labor guideline are more permissive of slowed labor progress, some fear that the incidence of Bandl's Band may rise. What is this ring? What is the pathophysiology of this abnormal uterine response? Can ultrasound detect this labor abnormality? In this episode we will cover the fascinating and controversial history of the Bandl Band and review some key

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00:05:33

How the Sausage is Made! 🤣😊😳

Dr. Chapa’s OBGYN Clinical Pearls ·

2023/07/10

Just a little description of what happens “behind the scenes“! Enjoy. 😊😊❤️❤️😩😩

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1,099 results

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